Classifications of Periodontal Disease

Everyone lives with a small amount of inflammation and bacteria in their mouths, but it is when this bacterial infection in the gums proceeds to chew away at the bone that supports the tooth that we are diagnosed with periodontal disease.  Periodontal disease often goes undetected by the patient because there is no pain associated with the disease.  That is until teeth become loose, gums become red and inflammed and they begin to bleed when they are flossed or brushed.

In 2017, more than 170 clinicians and researchers came together to redefine the way that we classify periodontal disease.  Now, using language similar to that used in oncology (i.e., Stage 1 through 4) we are able to communicate the severity and rate of disease progression to patients and other clinicians better than ever before.

Your periodontist is a specialist in the gums and bone that support the teeth.  They collect information such as the depth of the pockets around your teeth, the amount of bone that’s been lost around the teeth (as seen on an x-ray), and the amount of bleeding and inflammation, and other factors like diabetes and smoking status to give an accurate diagnosis.  The diagnosis is made up of two factors, stage and grade.

First, a patients stage of disease is like the GPS of a car.  Stage describes the severity and complexity of the disease.  How straight of a path are we on from health to severe disease.  Staging of periodontal disease can rank from Stage 1, incipient periodontitis through to Stage 4, advanced periodontitis with extensive tooth loss.

Secondly, a patients grade of disease is like the speedometer of a care.  Grade describes how quickly the disease is progressing.  How fast are we moving from health to disease.  Grading of periodontal disease can rank from Grade A, slow rate through to Grade B, rapid rate.

Both smoking and diabetes status are known factors that can influence our Grade, how fast we are progressing from health to disease.  Being a non-smoker and having normal, controlled blood glucose levels slows the rate of progression.  Smoking more than 10 cigarettes per day and/or having an HbA1c greater than 7% rapidly increase the rate of disease progression.

Your periodontal diagnosis and classification should be updated every 5 years with a full mouth series of x-rays conducted at your periodontal office or general dentist.

The best way to prevent and to treat periodontal disease is by regular visits to your dental office as well as putting a high priority on oral hygiene at home.

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